高数量和特定合并症可能会影响 COVID-19 患者的免疫反应。
High Number and Specific Comorbidities Could Impact the Immune Response in COVID-19 Patients.
机构信息
Department of Internal Medicine, Public Health and Clinical Centre of Chengdu, Chengdu, China.
Public Health and Clinical Centre of Chengdu Substation, Chengdu New Emergent Infectious Disease Prevention and Control Workstation, Chengdu, China.
出版信息
Front Immunol. 2022 Jul 5;13:899930. doi: 10.3389/fimmu.2022.899930. eCollection 2022.
BACKGROUND
Cellular immunodeficiency and comorbidities are common in COVID-19 patients.
AIM
The purpose of this study was to investigate comorbidities impacting on the cellular immunity in COVID-19 patients.
METHODS
The research objects included 55 healthy controls and 718 COVID-19 patients who divided into the control group and the COVID-19 group, respectively. Those in the COVID-19 group were divided into subgroups on the basis of the number and types of comorbidities present. Lymphocyte itself and its subsets were compared between the control group and the COVID-19 group, the groups with comorbidities based on the different number and types of comorbidities, and the relationship between the lymphocyte counts and subsets with the number and types of comorbidities was investigated.
RESULTS
Compared with the control group, the lymphocyte counts and T cell subsets were significantly increased in the groups with comorbidities, but both B and NK cell subsets were significantly decreased in the no comorbidity group and in most of the groups with comorbidities (all P<0.05). In the three comorbidities group, the lymphocyte counts and T cell subsets were all significantly decreased, but the CD56+ percentage was obviously increased (all P<0.05). The number of comorbidities was negatively correlated with the lymphocyte counts and the T and NK cell subsets. A negative correlation also existed between cancer and both the lymphocyte counts and the T cell subsets, between chronic hepatitis B and the lymphocyte counts, and between chronic kidney disease and the CD3+ counts. A positive correlation existed between nonalcoholic fatty liver disease (NAFLD) disease and both lymphocyte and CD3+ counts. The risk factors were number of comorbidities for the lymphocyte count, CD3+CD4+ and CD3+CD8+ percentages, NAFLD for the lymphocyte and CD3+ counts, cardiovascular diseases for CD3+CD4+ and CD3+CD8+ percentages, diabetes mellitus for the CD3+CD8+ percentage, and cancer for the CD3+ percentage, respectively.
CONCLUSIONS
High numbers of comorbidities and specific comorbidities could impact the immune response of COVID-19 patients. This study provides a reference for clinicians in the identification of suitable and timely immunotherapy for COVID-19 patients.
CLINICAL TRIAL REGISTRY
https://www.chictr.org.cn/enindex.aspx, identifier ChiCTR2000034563.
背景
细胞免疫缺陷和合并症在 COVID-19 患者中很常见。
目的
本研究旨在探讨影响 COVID-19 患者细胞免疫的合并症。
方法
研究对象包括 55 名健康对照者和 718 名 COVID-19 患者，分别分为对照组和 COVID-19 组。COVID-19 组根据合并症的数量和类型进一步分为亚组。比较对照组和 COVID-19 组、不同数量和类型合并症的组之间的淋巴细胞及其亚群，探讨淋巴细胞计数和亚群与合并症数量和类型的关系。
结果
与对照组相比，有合并症的组淋巴细胞计数和 T 细胞亚群显著增加，但无合并症组和大多数有合并症的组 B 细胞和 NK 细胞亚群显著减少（均 P<0.05）。在三种合并症组中，淋巴细胞计数和 T 细胞亚群均显著下降，但 CD56+百分比明显升高（均 P<0.05）。合并症数量与淋巴细胞计数和 T、NK 细胞亚群呈负相关。癌症与淋巴细胞计数和 T 细胞亚群呈负相关，与慢性乙型肝炎与淋巴细胞计数呈负相关，与慢性肾脏病与 CD3+计数呈负相关。非酒精性脂肪性肝病（NAFLD）与淋巴细胞和 CD3+计数呈正相关。淋巴细胞计数、CD3+CD4+和 CD3+CD8+百分比的危险因素是合并症数量，淋巴细胞和 CD3+计数的危险因素是 NAFLD，CD3+CD4+和 CD3+CD8+百分比的危险因素是心血管疾病，CD3+CD8+百分比的危险因素是糖尿病，CD3+百分比的危险因素是癌症。
结论
大量合并症和特定合并症可能会影响 COVID-19 患者的免疫反应。本研究为临床医生识别 COVID-19 患者合适和及时的免疫治疗提供了参考。
临床试验注册
https://www.chictr.org.cn/enindex.aspx，标识符 ChiCTR2000034563。
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